Chapter 2 Cardiology Part 1

Chapter 2 Cardiology 1) Which of the following risk factors has been proven to increase the risk of cardiovascular disease? A) Oral contraceptive use B) Type A personality C) Stress D) Lack of exercise Answer: D Diff: 1 Page Ref: 52 Standard: Medicine (Cardiovascular) Objective: 3 2) Public education about cardiovascular disease focuses on: A) risk factors and signs and symptoms of CVD. B) CPR and public access defibrillation. C) CPR and signs and symptoms of CVD. D) risk factors and public-access defibrillation. Answer: A Diff: 1 Page Ref: 52 Standard: Medicine (Cardiovascular) Objective: 2 22 3) The valve between the right atrium and right ventricle is the ________ valve. A) bicuspid B) pulmonic C) tricuspid D) aortic Answer: C Diff: 1 Page Ref: 55 Standard: Medicine (Cardiovascular) Objective: 4 4) Blood entering the left atrium arrives via the: A) bicuspid valve. B) superior and inferior vena cava. C) pulmonary vein. D) pulmonary artery. Answer: C Diff: 1 Page Ref: 55 Standard: Medicine (Cardiovascular) Objective: 4 5) The first part of the aorta as it leaves the heart is the: A) aortic arch. B) thoracic aorta. C) descending aorta. D) ascending aorta. Answer: D Diff: 1 Page Ref: 55 Standard: Medicine (Cardiovascular) Objective: 4 6) Your patient is a 54-year-old male who is unresponsive and cyanotic and has agonal respirations. A "quick look" shows ventricular tachycardia. Which of the following is most important when determining the immediate treatment of this patient? A) How long he has been "down" B) Whether he has a pulse C) Whether he is allergic to lidocaine D) Whether he has an implanted cardioverter-defibrillator Answer: B Diff: 2 Page Ref: 140, 141 Standard: Medicine (Cardiovascular) Objective: 9, 20 23 7) ECG findings associated with hypokalemia include: A) U waves and flat T waves. B) U waves and an Osborn wave. C) an Osborn wave and a "J" wave. D) flattened T waves and a widened QRS complex. Answer: A Diff: 2 Page Ref: 109 Standard: Medicine (Cardiovascular) Objective: 8 8) The presence of inverted T waves on an ECG indicates: A) myocardial infarction. B) myocardial necrosis. C) myocardial ischemia. D) myocardial injury. Answer: C Diff: 2 Page Ref: 73 Standard: Medicine (Cardiovascular) Objective: 8 9) The pressure in the left ventricle at the end of diastole is called: A) after. B) preload. C) ejection fraction. D) stroke volume. Answer: B Diff: 1 Page Ref: 58 Standard: Medicine (Cardiovascular) Objective: 1, 4 10) Typical stroke volume is about ________ of the volume of the left ventricle. A) one-third B) one-half C) two-thirds D) three-quarters Answer: C Diff: 1 Page Ref: 58 Standard: Medicine (Cardiovascular) Objective: 1, 4 24 11) Which of the following items is most likely to interfere with the function of an implanted cardiac pacemaker? A) Magnet B) Cellular telephone C) Television remote control D) Hair dryer Answer: A Diff: 1 Page Ref: 107, 108 Standard: Medicine (Cardiovascular) Objective: 8 12) The first phase of the cardiac cycle is: A) systole. B) diastole. C) contraction. D) ejection. Answer: B Diff: 1 Page Ref: 57 Standard: Medicine (Cardiovascular) Objective: 4 13) For a resting potential in a cardiac cell to exist, there must be an: A) adequate number of potassium ions inside the cell and sodium ions outside the cell. B) adequate number of sodium ions inside the cell and potassium ions outside the cell. C) influx of calcium ions into the cell. D) ionic equilibrium between the inside and outside of the cell. Answer: A Diff: 2 Page Ref: 63 Standard: Medicine (Cardiovascular) Objective: 1, 4 14) The proportion of the left ventricular volume that is pumped out of the heart during systole is the: A) ejection fraction. B) stroke volume. C) preload. D) afterload. Answer: A Diff: 2 Page Ref: 58 Standard: Medicine (Cardiovascular) Objective: 1, 4 25 15) Beta-blockers generally have which of the following effects? A) Increased cardiac conduction B) Decreased myocardial contractility C) Vasoconstriction D) Increased myocardial contractility Answer: B Diff: 2 Page Ref: 61 Standard: Medicine (Cardiovascular) Objective: 4 16) Your patient is found sitting on the edge of the bathtub with cool, diaphoretic skin. She states she became lightheaded and nearly "passed out" while vomiting. Your cardiac monitor shows a sinus bradycardia at a rate of 48. Which of the following is most likely? A) Sick sinus syndrome B) Use of sympathomimetic medications C) Disease of the cardiac conduction system D) Increased parasympathetic tone Answer: D Diff: 2 Page Ref: 76 Standard: Medicine (Cardiovascular) Objective: 8 17) When the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals: A) 0.08 seconds. B) 0.12 seconds. C) 0.20 seconds. D) 0.24 seconds. Answer: C Diff: 2 Page Ref: 68 Standard: Medicine (Cardiovascular) Objective: 5 18) Which of the following will occur with an increase in peripheral vascular resistance? A) Decreased stroke volume B) Increased ejection fraction C) Increased preload D) Decreased afterload Answer: A Diff: 2 Page Ref: 58 Standard: Medicine (Cardiovascular) Objective: 4 26 19) There are 15 small boxes between R waves on an ECG tracing. What is the heart rate? A) 150 B) 120 C) 100 D) 20 Answer: C Diff: 2 Page Ref: 68 Standard: Medicine (Cardiovascular) Objective: 5 20) If the stroke volume decreased, which of the following would occur to maintain the blood pressure at its current value? A) Increased heart rate and increased peripheral vascular resistance B) Decreased heart rate and decreased peripheral vascular resistance C) Increased heart rate and decreased peripheral vascular resistance D) Decreased heart rate and increased peripheral vascular resistance Answer: A Diff: 2 Page Ref: 58 Standard: Medicine (Cardiovascular) Objective: 4 21) You have administered a drug with potent beta-1 effects. Which of the following effects should you most anticipate? A) Smooth muscle relaxation B) Peripheral vasoconstriction C) Increased heart rate D) Peripheral vasodilation Answer: C Diff: 2 Page Ref: 61 Standard: Medicine (Cardiovascular) Objective: 4 22) You have administered a medication to a patient, resulting in a decreased speed of cardiac impulse conduction. This drug is most accurately described as having a ________ effect. A) negative dromotropic B) negative chronotropic C) positive dromotropic D) positive chronotropic Answer: A Diff: 2 Page Ref: 61, 62 Standard: Medicine (Cardiovascular) Objective: 4 27 23) Which of the following endocrine substances acts as a marker for congestive heart failure? A) BNP B) Angiotensin C) ACTH D) Troponin Answer: A Diff: 1 Page Ref: 62 Standard: Medicine (Cardiovascular) Objective: 4 24) To detect life-threatening cardiac dysrhythmias, the paramedic must view the ECG in ________ lead(s). A) two B) one C) three D) twelve Answer: B Diff: 1 Page Ref: 67 Standard: Medicine (Cardiovascular) Objective: 5 25) The total duration of ventricular depolarization is represented by the ________ on the ECG. A) QRS duration B) QT interval C) PQ interval D) R-R interval Answer: B Diff: 2 Page Ref: 71-72 Standard: Medicine (Cardiovascular) Objective: 6 26) Which of the following statements concerning Q waves on the ECG is most accurate? A) Q waves are not a normal finding on the ECG. B) The absence of a Q wave is a significant pathophysiological finding. C) A Q wave is significant if it is 0.04 or more seconds wide. D) A Q wave is only significant in the presence of chest pain. Answer: C Diff: 2 Page Ref: 73 Standard: Medicine (Cardiovascular) Objective: 6 28 27) Which of the following is most characteristic of right heart failure? A) JVD, peripheral edema, and pulmonary edema B) Rales, cough productive of blood-tinged sputum C) Ascites, peripheral edema, and cyanosis D) JVD, peripheral edema, and liver and spleen engorgement Answer: D Diff: 2 Page Ref: 141, 142 Standard: Medicine (Cardiovascular) Objective: 12 28) The anterior surface of the heart is best viewed by ECG leads: A) II, III, and aVF. B) V1-V4. C) I and aVL. D) aVR, aVL, and aVF. Answer: B Diff: 2 Page Ref: 73 Standard: Medicine (Cardiovascular) Objective: 6, 19 29) While monitoring a patient's cardiac rhythm, you note that there is no electrical activity after a PQRST complex for a period equal to exactly three of the previous R-R intervals. This is most accurately described as: A) sinus arrest. B) sinus pause. C) sinus arrhythmia. D) sinus block. Answer: D Diff: 3 Page Ref: 76 Standard: Medicine (Cardiovascular) Objective: 7, 14 30) A 48-year-old male is sitting upright in bed in respiratory distress. He describes an acute onset of difficulty breathing and chest pain during the night that has been worsening for the past 3 hours. He also complains of nausea. Pain is described as a substernal pressure radiating to his left shoulder. Physical examination reveals cool, diaphoretic skin and rales on auscultation bilaterally. Medical history includes two prior myocardial infarctions. Medications include Zestril and metoprolol. HR = 132, BP = 140/100, RR = 25, SaO2 = 92%. Which of the following is NOT indicated? A) Adenosine B) Enalapril C) Morphine D) Nitroglycerin Answer: A Diff: 3 Page Ref: 120-122, 142 Standard: Medicine (Cardiovascular) Objective: 11, 20 29 31) Which of the following is the most likely result of increased pulmonary artery pressure? A) Increased left ventricular workload and cor pulmonale B) Increased right ventricular workload and cor pulmonale C) Decreased right atrial workload and right ventricular hypertrophy D) Increased left ventricular workload and congestive heart failure Answer: B Diff: 2 Page Ref: 139-140 Standard: Medicine (Cardiovascular) Objective: 12 32) The difference between apical and peripheral pulse rates that results from decreased cardiac output when the atria fail to contract is known as: A) pulsus paradoxus. B) pulse deficit. C) pulsus alternans. D) paroxysmal pulse pressure. Answer: B Diff: 2 Page Ref: 88, 116 Standard: Medicine (Cardiovascular) Objective: 10 33) Elastic and smooth muscle fibers are primarily found in the tunica ________ of blood vessels. A) collateralus B) media C) adventitia D) intima Answer: B Diff: 1 Page Ref: 57 Standard: Medicine (Cardiovascular) Objective: 4 34) ________ is a drop in systolic blood pressure of more than 10 mmHg with inspiration. A) Electrical alternans B) Pulsus alternans C) Pulse deficit D) Pulsus paradoxus Answer: D Diff: 2 Page Ref: 142 Standard: Medicine (Cardiovascular) Objective: 12 30